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Individual

MICHELLE JORDAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LDO

Contact information

Practice address
1505 COUNTY ROAD 220, FLEMING ISLAND, FL 32003-7926
(904) 215-4945
(904) 264-2871
Mailing address
1505 COUNTY ROAD 220, FLEMING ISLAND, FL 32003-7926
(904) 215-4945
(904) 264-2871

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO5615
FL

Other

Enumeration date
05/23/2023
Last updated
05/23/2023
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